AIMS: To compare both short- and long-term stability and pacing parameters of CS leads. Long-term maintenance of coronary sinus (CS) pacing lead position has not yet been assessed by serial X-ray digital imaging. METHODS AND RESULTS: Using X-ray digital imaging in anteroposterior and left lateral views, we performed analysis of ...

To quantify cardiac apex rotation (CAR), the authors recently proposed the use of a Coriolis force sensor (gyroscope) as an alternative to other complex techniques. The aim of this study was to evaluate the effects of right ventricular (RV) pacing on CAR. A sheep heart was initially paced from the ...

BACKGROUND: Heart rate can affect cardiac function, but the importance of rates lower than 100 paced beats per minute is unknown. We therefore sought to evaluate the impact of different heart rates on ejection fraction, 6-minute walk, and peak oxygen consumption (VO2) in heart failure patients. METHODS AND RESULTS: We ...

Right ventricular (RV) pacing has been shown to cause heart failure symptoms in patients with and without previous systolic left ventricular (LV) dysfunction. The aim here was to evaluate the preventive effect of biventricular pacing vs. RV apical pacing in patients with indication for permanent ventricular pacing. Methods PREVENT-HF is ...

AIMS: Endocardial (ENDO) or epicardial (EPI) pacing systems are implanted in infants but it remains unclear which system should be preferred. METHODS AND RESULTS: We evaluated the results of children <or=1 year who underwent pacemaker (PM) implantation at our centre with a retrospective analysis. Between 1992 and 2004, 56 patients, ...

OBJECTIVE: To investigate whether transoesophageal cardiac pacing can induce ventricular fibrillation (VF) and how long the cardiac pacing has to be sustained to prevent the reversion of the VF induced. METHODS: A pacing electrode was inserted orally into the oesophagus and high-frequency ventricular pacing was performed so as to elicit ...

Abnormal electrical activation of the left ventricle results in mechanical dyssynchrony, which is in part characterized by early stretch of late-activated myofibers. To describe the pattern of deformation during "prestretch" and gain insight into its causes and sequelae, we implanted midwall and transmural arrays of radiopaque markers into the left ...

INTRODUCTION: The purpose of this study was to examine BiV pacing-dependent changes in QT interval and the related potential for proarrhythmia. Biventricular (BiV) pacing has emerged as a promising therapy for patients with advanced congestive heart failure (CHF) and bundle branch block (BBB). METHODS AND RESULTS: One hundred and seventy-six ...

Cardiac memory is usually observed after right ventricular apical pacing and considered to be related to alter asynchronous activation by apical pacing. However, it is not known whether it occurs by unaltered high to low synchronous ventricular activation by right ventricular outflow tract (RVOT) pacing. We present here a case ...

BACKGROUND: Although several randomized trials have detected no reduction in major cardiovascular events with the routine use of dual-chamber as opposed to ventricular pacemakers, many individuals continue to advocate their use as a means of improving exercise capacity. METHODS: The Canadian Trial of Physiological Pacing (CTOPP) trial is the largest ...

Although the overall need for emergency pacing following AMI has reduced with the wide spread use of thrombolysis the availability of transcutaneous pacing offers an emergency non-invasive strategy to optimise circulation following CHB or ventricular standstill. Transcutaneous pacing also facilitates the safe instigation of thrombolytic therapy to achieve reperfusion of ...

BACKGROUND: Excessive right ventricular (RV) pacing has been associated with adverse clinical outcomes in patients receiving pacemakers or implantable cardioverter-defibrillators (ICDs). It remains uncertain how much RV pacing is clinically deleterious. OBJECTIVE: This retrospective analysis assessed the relationship between the amount of RV pacing and the composite of all-cause mortality ...

A 56-year-old woman underwent placement of a permanent pacemaker to treat symptomatic bradycardia; she had a documented, severe atrioventricular (AV) conduction abnormality and was not taking any AV node-blocking drugs. She had a mechanical prosthetic valve in the tricuspid position, which had been implanted for severe valvular insufficiency caused by ...

OBJECTIVE: To determine the sequela of right ventricular pacing in children with congenital complete atrioventricular block. BACKGROUND: Pacing is a well-accepted therapy for patients with congenital complete atrioventricular block. The long-term sequela of right ventricular pacing in this population has not been well described. METHODS: We performed a cohort study ...

Pacing from the right ventricular apex is associated with long-term adverse effects on left ventricular function. This has fuelled interest in alternative pacing sites, especially the septal aspect of the right ventricular outflow tract (RVOT). However, it is a common perception that septal RVOT pacing is difficult to achieve. In ...

Biventricular (BV) pacing is an established therapy for heart failure (HF) patients with intraventricular conduction delay, but not all patients improved clinically. We investigated the interventricular delay (IVD) by means of the transesophageal left ventricular posterior wall potential (LVPWP). A total of 18 HF patients (age 62+/-9 years; 15 males) ...

Sick sinus syndrome with symptomatic bradycardia is an indication for a permanent pacemaker. Either a single (AAIR) or dual-chamber (DDDR) pacemaker can be implanted in these patients with normal atrioventricular nodal function. This report presents a 92-year-old male with right ventricular apical pacing related recurrent acute pulmonary edema and mechanical ...

BACKGROUND: Enthusiasm for the development of Ca2+ sensitizers as inotropic agents for heart failure has been tempered by reports of impaired relaxation. Levosimendan, which increases myofilament Ca2+ sensitivity via Ca2+-dependent binding to troponin C, exerts positive inotropic and lusitropic effects in failing human myocardium in vitro. We sought to determine ...

BACKGROUND: A 64-year-old woman was referred to our center because of poorly tolerated ventricular tachycardia (VT) at 210 bpm due to an old myocardial infarction. The patient had been operated on at age of 20 for mitral valve commissurolysis, at age of 49 for ductal carcinoma, at age of 56 ...

BACKGROUND: Optimizing atrioventricular (AV) delay during biventricular (BiV) pacemaker implantation can require substantial resources. Hence, a simpler method is desirable. We hypothesized that interatrial conduction time (IACT), measured at the time of BiV device implant, could be a surrogate value for the optimal AV delay. OBJECTIVE: This study determined the ...

PURPOSE OF REVIEW: Advances in pacemaker lead designs, permitting precise lead implantation at sites other than the ventricular apex, have provoked interest in the utilization of ventricular pacing beyond maintenance of heart rate. Select older adult patients with various cardiomyopathies may improve clinically following alternative site, biventricular and cardiac resynchronization ...

A 62-year-old woman with Ebstein's anomaly and a tricuspid valve prosthesis underwent placement of a permanent atrioventricular pacemaker to treat highly symptomatic sinus node dysfunction and atrioventricular block. Transvenous bipolar leads were placed in the anterior cardiac and lateral coronary veins and were set to optimal ventricular pacing parameters to ...

Epicardial wires allow temporary pacing after cardiac surgery. Pacing is often the best, and sometimes the only method of treating temporary rhythm disturbances in this context. Temporary epicardial pacing has evolved from simple one-chamber systems to dual chamber, biatrial, and even biventricular systems. The first part of this two-part review ...

BACKGROUND: The aim of this study was to assess the efficacy of high-frequency (HF) pacing from the right atrial appendage (RAA) or coronary sinus ostium (CS-Os) for the termination of acute atrial fibrillation (AF) and atypical atrial flutter (AAFL) during an electrophysiological (EP) study. METHODS: 128 episodes of acute fast ...

We report here on three patients who underwent biventricular pacing (BVP) for severe heart failure and the problems encountered with pseudo-bipolar left ventricular (LV) lead configuration. With this configuration, right ventricular anode capture with simultaneous biventricular stimulation was noted at higher output during the isolated LV pacing mode in these ...

More than 80 years after its first description by Eduard Schott, percussion (fist) pacing remains a little known procedure even though it represents an instantly available and easy to perform treatment for temporary emergency cardiac pacing in haemodynamically unstable bradycardias, including bradycardic pulseless electrical activity and complete heart block with ...

To determine the effects of interventricular pacing interval and left ventricular (LV) pacing site on ventricular dyssynchrony and function at baseline and during biventricular pacing, using tissue Doppler imaging. Using an angioplasty wire to pace the left ventricle, 20 patients with heart failure and left bundle branch block underwent temporary ...

Coronary sinus perforation is a relatively uncommon but much feared complication that may occur during the placement of left ventricular pacing lead. Coronary sinus perforation, especially in the presence of an obstructive flap, usually indicates the need to abandon the implantation attempt, as there are difficulties in crossing the obstructive ...

Ventricular Capture Management (VCM) is a Medtronic Kappa pacemakers (PM) feature that automatically measures pacing threshold through detection of the evoked response after a pacing stimulus. The aim of this study was to evaluate the range of variation of ventricular pacing threshold in pediatric patients with endocardial and epicardial pacing ...

A three-dimensional electroanatomic bipolar voltage map of the right atrium was performed in a 20-year-old patient with functional single-ventricle physiology after a classic Fontan-type operation who presented with clinical signs of heart failure, a dilated right atrium, protein-losing enteropathy, and sinus node dysfunction. Previous pacemaker upgrading to a DDD system ...

PURPOSE OF REVIEW: Clinical trial evidence suggests that traditional right ventricular apical pacing may be harmful. This review summarizes the existing evidence and outlines the major avenues of ongoing research in this field. RECENT FINDINGS: Despite theoretical advantages of dual-chamber pacing, large randomized trials found only a small advantage over ...

BACKGROUND: Chronic right ventricular apical pacing may have detrimental effect on left ventricular function and may promote to heart failure in adult patients with left ventricular dysfunction. METHODS: A group of 99 pediatric patients with previously implanted pacemaker was studied retrospectively. Forty-three patients (21 males) had isolated congenital complete or ...

Right Ventricular Apical permanent pacing could have negative hemodynamic effects. A physiologic pacing modality should preserve a correct atrio-ventricular and interventricular synchronization. This can be obtained through biventricular pacing, left ventricular pacing, or from alternative right ventricular pacing sites. Direct His Bundle Pacing (DHBP) was documented as reliable and effective ...

INTRODUCTION: Previous studies have suggested that, among septal sites, the inferior portion of the interatrial septum (IAS) is the most likely to prevent atrial fibrillation, though inserting an active fixation lead at this site can be tedious and time consuming. We describe a relatively straightforward technique to insert a lead ...

We report a case of long-term, successful, endocardial atrioventricular pacing in a 32-year-old man who had severe heart failure and ascites after having undergone a Fontan procedure for tricuspid atresia 9 years earlier. The patient was referred to our hospital for Fontan revision. However, electroanatomic mapping of the right atrium ...

Patients with congestive heart failure have impaired cognitive function, possibly caused by impaired global and regional cerebral blood flow. We hypothesized that biventricular pacing-simultaneous activation of the both the septum and the lateral wall of the left ventricle-would improve neurocognitive function and improve quality of life. Ten patients were examined ...

Permanent cardiac pacing is nowadays a widespread method for the cure of conduction system diseases, improving quality of life and often saving patients' lives. In the twentieth century, scientific efforts were focused on extending battery life, improving sensitivity and reliability, minimizing the dimensions of the device and restoring atrio-ventricular synchrony ...

BACKGROUND: The aim of this prospective study was to evaluate the effect of the closed loop stimulation (CLS) on the ejection fraction in pediatric patients, affected by complete atrioventricular block (CAVB) or CAVB and sinus node dysfunction (SND), with a previously implanted pacemaker (PM) and ventricular dysfunction. The role of ...

BACKGROUND: Cardiac resynchronization therapy has been shown to be an effective treatment to improve functional status and prolong survival among patients with advanced congestive heart failure. However, as many as 30% of patients do not respond. Nonresponse may be due to suboptimal left ventricular lead placement. Studies have indicated that ...

About 30% of patients with left ventricular systolic dysfunction also have ventricular conduction delays (prolonged QRS duration greater than 0.12 second) most frequently seen as left bundle branch block. This intraventricular conduction delay causes nonsynchronous ventricular activation between the right ventricle and the left ventricle (or dyssychrony), compromising cardiac function. ...

In this case report, we describe inappropriate pacing in a patient with a newly implanted biventricular pacing system with three epicardial leads. Very high pacing thresholds resulted from the use of nonsteroid eluting leads, and unusual pacing behavior was due to the chosen implant locations for the right atrial and ...